(Rev, 6/O4)
NOTICE TO COUNSEL: Service ofProcess must be in accordance with Fed. R. Civ. P. 4(i) and 20 C.F.R. Part 423.
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
SHAUN A . PARKS,
(Plaintiff)
V. Civil Action N0.
MICHAEL J . ASTRUE ,
(Commissioner, Social Security Administration)
(Defendant)
COMPLAINT
l. The plaintiff, whose Social Security Account Number ends in the last four digits ***-**- Q L 2 Q, and whe
is a resident of Wi lmincg IQOI1 j Delaware 19804 , seeks
(City) (State, zip code)
judicial review pursuant to 42 U.S.C_ 405(g) of an adverse decision ofthe defendant which has become final and bears
the following caption;
In the case of Claim for
Shaun A. Parks Iitle II and Iitle XVI
Claimant
***-**- _6l9§ _ (last four digits of Social Security No.)
Wage Earner
2. Plaintiff has exhausted administrative remedies.
WHEREFORE, plaintiff seeks a judgement for such relief as may be proper including costs and attorney’s fees.
J ,'
fi 'J/§L»L·-2
ii Signature
Gary L. Smith, I .D. #2317
Attorney for Plaintiff
1400 Peoples Plaza, #110
Newark, DE 19702
_, ` lg ` (City) (State) (Zip)
Dated: `2 3 i 6 cg (302) 834-9400
(Area code) Telephone No.
Case 1 :08-cv-0051 7-N LH Document 2-2 Filed 08/14/2008 Page 1 of 1
iso tw. wi CIVIL COVER SHEET
Tit; J5-44 civil cover street and the information contained licrcitt ttcillter replace nor supglement tlic Fling and service ofplcadittgs or other papers as rc mmd
bylaw, except aslprovidcd by local mics ofcourt._ Tlus form, approved by the Judicial onfcrcnce oftlic United States tn September I974, is required Igor the
irsc oftlic Clcrl; o Court for the purpose ofinitiatmg the civil docket slieet. (SEE INSTRUCTIONS ON THE REVERSE OF THE FORM.)
I. (tt) PLAINTIFITS DEFENDANTS
Shaun A _ Pal-ks Michael J . Aetirue, Cornmissiotieir
Social Security Admiriistiratiori
(b) County ofResidence of First Listed Plaintiff New Castle County of Residence of First Listed
(EXCEPT IN U.S, PLAINTIFF CASES) (IN U.S, PLAINTIFF CASES ONLY)
NOTE; IN LAND CONDEMNATION CASES, USE THE LOCATION OF THE
LAND INVOLVED.
(Q) Attoi·ney's (Finn Name, Address, and Telephone Number) AII¤¤`¤¢>’S (IfKJt¤W¤)
Gary L. Smith
1600 Peoples Plaza , Suite 110
1* DE 19702
New I“> 302) 834-9400
JI. BASIS OF JURISDICTJON (Place an "X" in One Box Only) III. CITIZENSHIP OF PARTIES(Place an "X" in One Box for Plaintiff
(FOI Diversity Cases Only) and One Box for Defendant)
DEF DEF
El I U.S. Govemment G 3 Federal Question Citizen ofThis State ® l El I Incorporated or Principal Place El 4 I] 4
Plaintiff (U.S. Government Not a Patty) ofBusiness In This State
[X2 U.S. Government I] 4 Diversi Citizen of Another State I] 2 I] 2 Incorporated arid Princi al Place I] 5 [] 5
_ _ IY t>
Defendant (Indicate Citizenship of Parties of Business In Another State
in Item lll)
Citizen or Subject ofa E3 3 Cl 3 Foreign Nation El 6 I] 6
· F rei in otintr
IV. NATURE OF SUIT Place an"X"in One Box Onl .
CONTRACT TORTS FORFEl1`LtRE/PI2NAI,1`\’ BANKRUPTCY OTHER STATUTES
Cl Il0 lnsunrnce PERSONAL INJURY PERSONAL INJURY U 6I0 Agriculture I] 422 Appeal 28 USC l58 I] 400 State Reapportionment
Cl l20 Marine I] 3l0 Airplane Cl 362 Personal Injury- U 620 Other Food & Drug I] 4 IO Antitrust
El l30 Miller Act I] 3I5 Airplane Product Med. Malpractice EJ 625 Drug Related Seizure I] 423 Withdrawal . I] 430 Banks and Banking
Cl l40 Negotiable Instrument Liability I] 365 Personal Injury- of Property 2I USC 28 USC l57 I] 450 C0rnmercdICC Rates/etc.
C] l50 Recovery rifOvr:rp;rymcnt I;] 320 Assault, Libcl dk Product Liability D 630 Liquor Laws I] 460 Deportation
& lfrrforcrzrrrerit oflrrtlgrrtent Slarttler I] 368 Asbestos Persorrzrl I] 640 R,R. & Truck PROPERTY RIGHTS El 470 Rackeleet Influenced and
[I l5l Medicare Act I] 330 Federal Emp|oyers` Injury |‘roduct E1 650 Airline Regs. U H20 C wm Corrupt Organiyntions
I] l52 llccnvcry r»t't)·;t’.nr|rer| Liability Liability I] 660 Occupational D No Popynb S I] SIG Sclectivc Service
Student Loans D 340 Marine |‘lfllS()N.~\I. l’R()l’FZR`l`\’ Safety/Healtlt G SI1 Tziicm rk I] 850 Securitics/Contrrtotlitiey
(Excl. \'cIcr.rris) I] 345 Marine Product [J 370 Otlrct I-ruutl CI 690 Otlrcr U Mdcma Exchange
I] l53 |lr:ct»very rrf()verp;tynrcrrt Liability D 37l lrtitli in Lending _ I] 875 Customer (`Irullcrige
or true.-arts rrarrerus tj ssa timer Vclriclc I] nrc ririirr-r·t-rsarmi LABOR SOCIAL SECUIII IY rz usc 3410
Cl l60 Sto·;k|rolders` Suits IJ 355 Motor Vehicle Propcny Uantagc __. _ _ I] 89I Agricultural Acts
I] |90 Otlicr Corrttact Product Liability D 385 Property Damage D No I/QM; I**I’°‘ Smndarih EI l£95ID923 I] 892 Economic Stabilization Act
Cl W5 Cotittart tnoitrrct Liability lj my Orlrer Personal rntrriy p,-Dirac. Ltabrigry ° _ M ¤¤t—»l l D 893 Elwiwnmcmi Mmm
Cl 720 Labor/Mgint. Relations IX 863 DIWC/DIWW (405(g)) D 894 Energy Allocmon ACI
ru—:At. r·tior·rarrr‘v crvrt, tucrtts rrtrsotvert t>n’rr’trot~ts _ O W $$*0 Tttlc XVI rj B9j Fpccdcrn of
I] 730 Labor/Mgmt.Reportrng I] 865 RSI (405(g)) Infommlion AC!
D 2l0 Lund Contlernnatiort I] 44l Voting U 5I0 Motions to Vacule & Disclosure Act , D 900/it ml {F cDdCm1in¤l.On
I] 220 Foreclosure I] 442 Employment Sentence I] 740 Railway [arbor Act FEDERAL TAX SUITS Lwdcr; uz! ACCCSS (O I
I] 230 Rent Lcasc 64 Ejectmcnt I] 443 Housing Hubcas Corpus: U 870 T (U S Plai lm. JUSHCC q
I] 240 Torts to Land Accommodations [J 530 Gcncral Cl 790 Other Labor Litigation mgsf `I n Q 950 Consmummamy of
tj 245 rua iwtitrtiet Ltttlttrry tj 444 Welfare EJ sas Dent. marry °' ° °“ “"l Sm slams
I] 290 All Otlrct Rcnl Propcrty I] 440 Otlrcr Civil Rights g 240 Nlatidarnl-is & Olhcf El 79l Empl.-Ret, Inc, D X7] mS•_Third pany D 890 Olhcr Slammry Acliuns
50 Civil Rrglits Security Act _ 26 SC 7609
I] 555 Prison Condition · U
(PLACE AN "X" IN ONE BOX ONLY) A peat to
V· ORIGIN Transferred from Diztrict
another district Judge from
IX I Origitiztl I] 2 Removed hom IH 3 Rcinutttled litttn KI 4 Reittstaled or D 5 (specify) EI 6 Multidistrict L] I Magistrate
tmiceediii · ' State Court Appellate Court Rcopened Liti ation Jud intent
In E E
. _. ( .. (Citc tlic U.S. Civil Statute under uliicli you are hling and write hricfstatcnrent ofcausc.
O F D0 not citejurrsdictiiirttrl statutex rirrlcss diversity.)
42 U. S. C. Sec. 605(g) · Social Security Appeal
VI I. It EQUILS°I`I:;I) IN I] cHt;ct< tr tins is A crass Acrroiv DEMAND s citt;ct< Ytzs only ttttemarttictt in eotttptattti;
COM|’|yA|N'l`; UNt>Et< t*.t
VIII. REL/\II`I;I) CASIXS) instructions)
IF ANY rumor; DOCKET
NUMIBLR .
IM ll , , MLN/tl'UttI, Ut A‘t`TOIINt;i’ Oli l([jCOtt[)
&l&_ ./UM; 0 1...
tort ot t‘t t‘ ti_=.r·; tltxir it /¤ _
lIlI`| It’t tt AA‘lllllNl /\t’l't\'lN
Case 1:08-cv-00517-NLH
Document 2
Filed 08/14/2008
Page 1 of 1
Case 1:08-cv-00517-NLH
Document 2-2
Filed 08/14/2008
Page 1 of 1
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